Although open lung biopsy is a very useful method for diagnosis of diffuse lung diseases, it is sometimes difficult to obtain patient's consent for it because of a major surgical procedure, thoracotomy and the application of closed lung biopsy, which is a relatively simple procedure and may be repeated easily, has been felt to be nesessary. A review of the previous reports of closed lung biopsy suggested that transbronchial lung biopsy by means of stomach biopsy forceps made by Machida Co., Ltd. introduced into the bronchial tree through Métras catheter in combination with bronchography (Shibayama et al, 1970) was the safest in them. However, the greatest disadvantage of this method was the smallness of the biopsy specimens (2.0×2.0mm, at the most) for diagnosis of diffuse lung disease. In order to obtain larger specimen hereafter, investigations were thought to be necessary as for the extent of hemorrhage and the state of recovery of biopsy wound in the lung after the transbronchial lung biopsy.
For this purpose the lungs of eight dogs were examined at different periods of time after two or more transbronchial lung biopsies. Besides, the size of biopsy specimens were observed in cerrelation with bronchography and respiratory rhythm.
(1) Hemorrhage of biopsy wound in the lung was seen in extent within 10mm in diameter immediately after biopsy, and was resorbed completely within 5 to 7 days after biopsy.
(2) Small lacerations of bronchial or bronchiolar walls were observed immediately after biopsy, and granulation tissues were formed in those places 3 days after biopsy. In 7 to 30 days after biopsy they developed into scar tissue.
(3) It was found that biopsied specimens were larger in the cases without bronchography than in the ones with bronchography.
(4) Moreover, larger specimens could be obtained when the cup of forceps was opend during inhalation and closed during exhalation.
In summary, biopsy wounds and its hemorrhagic lesions were smaller than expected, and the use of sharper edge of cup in forceps might improve the results to obtain larger specimen and to reduce the artificial deformity of obtained specimen.

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Pulmonary arterio-venous fistulas associated with Osler's disease in a 57 year old house wife and her 23 year old daughter were reported.
Pulmonary angiography showed bilateral multiple fistulas in both cases.
The 100% oxygen inhalation method revealed high intrapulmonary shunt rate up to 69.6% in mother and 34.8% in daughter.
The basal segmentectomy of left lower lobe was performed in mother and the shunt rate was improved from 69.6% to 23.1%.
Blood serotonin and urine 5-HIAA levels were measured and the arterio-venous difference of serotonin was decreased postoperatively by the improvement of intrapulmonary shunt.

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[in Japanese]

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